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11.09.2007

Curcumin, one of the polyphenols present in Turmeric, has a long track record of positive research relating to its anti-inflammatory, anti-cancer, and liver-protective effects. It is a mild and generally well-tolerated addition to the diet, and even concentrated extracts of the Turmeric rhizome (like New Chapter's TurmericForce) work well without having to take multiple daily tablespoons of the spice (see here for my articles on this spice).Now, Japanese researchers have gone in and chemically modified curcumin, which is already an isolated constituent of Turmeric and contains none of its beneficial mucilage and fewer aromatic constituents, and given these modified chemicals to rats with colorectal cancer. The results: the new chemicals seem to work better.My main comment on this research, other than the fact that it was performed on rats, is that it continues the misguided trend of taking botanical substances, refining them, and modifying them for an 'enhanced' effect in the human physiology. Historically, my favorite example of this trend is the opium -> morphine -> heroin chain, which has certainly done wonders for the human race. The problem with this approach is that we have no understanding of, and therefore no way to predict, the effects of long-term supplementation with substances our physiology hasn't ever seen. This is in contrast with unaltered, whole-plant preparations, which are not only familiar to our metabolic pathways, but probably created those pathways to begin with.In the long run, many modified chemicals, while potent in the short term, leave the body with unwanted side-effects and often further weaken the system. I am fully in support of ongoing research into the chemistry and effects of plant constituents, but please, let's wait a little until applying them to humans in refined, or modified, forms.

11.02.2007

This is the third and final post in a series reporting on this year's Herbalists' Guild convention. Part 1, Part 2.

Simon Mills, author of some of my favorite herb books such as Out of the Earth, lectured on his idea of acupharmacology. The basic concept is that part of herbal medicine's effects can be understood by observing their effects on the gastric mucosa, an internal second skin, and the reflex pathways between the gut wall and the rest of the physiology as modulated by the central nervous system. This is just one of the ways herbs do their thing - but if you've ever seen the effects of a demulcent on anxiety, you know what I mean.Simon went on to discuss the relationship of gut tissue not only with neurons, but also with the immune cells and tissues embedded in the gastric lymphatic system. The endocrine / immune secretions from these tissues serve as another channel of systemic effect, modulating stimuli received from herbs. He continued with a fascinating exploration of the role of the immune system in many pathological states. Some highlights:- Pierre Graber, old-school immunologist, described a different understanding of the immune system in a 1974 paper in the Lancet (not much info available online). Rather than a "police squad", he viewed the immune system as a clean-up crew to support digestive processes (by removing any antigenic protein chains left undigested) and to support tissue autolysis (help clean up old pieces of tissue to make way for the new). Additionally, antibodies seem, in Grabar's view, to be more like transport proteins than markers of certain doom. They attach to these incompletely digested proteins and pieces of old "self" to make sure they don't interfere with cell-to-cell signaling as they get escorted to phagocytosis.- Protein sequences on bacterial cell walls can be very similar to sequences found on our own cells. This has led to the identification of initial "insults" by bacteria which activate the immune response and lead it to attack self: for instance, Kelibsella and ankylosing spondylitis; Proteus bacteria and Parvovirus in rheumatoid arthritis; Mycobacteria and E. coli in Crohn's disease. This is not only interesting in terms of understanding autoimmunity, but reinforces the idea that herbs can modulate these inflammatory processes by acting through the immune system (and thus across the whole physiology) without their metabolites ever needing to leave the gut.

Along these lines, Kevin Spellman went into a fascinating discussion, including the presentation of his original research, on the role of Echinacea and Dandelion roots in treating an allergic reaction. The details:- three cases involving rashes, hives and anxiety following the ingestion of an unknown Chinese herbal formula (different in each case, I presume).- treatment with high doses (1tsp every 30 minues, roughly) or Echinacea and Dandelion root tinctures, which helped almost immediately (after the second dose).- Kevin proposed that Echinacea (and Dandelion, though differently -- perhaps through inulin and its acupharmacological effects) helped diminish the acute allergic Type-4 hypersensitivity in the three cases.- Echinacea modulates the expression of pro-inflammatory cytokines by acting on cannabinoid receptors on the surface of immune cells, and lessening the production of NF-kappaB and therefore the transcription and expression of inflammatory proteins.- Kevin (and Nadja Cech, amongst others) showed that Echinacea alkylamides suppress IL-2 production, a pro-inflammatory cell-to-cell signaling molecule. This build on previous research showing similar results.- Coupling these new results with Echinacea's history of use as an immune booster, we see a complex emerging picture of this plant as a true immunomodulator. Regardless, it gives us an interesting hypothesis for understanding how and why this plant might have helped in an allergic reaction! And, it continues to debunk the idea that Echinacea shouldn't be used in autoimmune conditions.

Robert Duggan, President of Tai Sophia, gave the keynote lecture at the banquet (love that Sheraton, guys!). He offered some beautifully iconoclastic pearls of wisdom:- Don't let people off the hook by telling them you will "treat" their disease. Illness is an ally!- Natural healing modalities function as ways to increase perception and consciousness, thereby allowing one to listen to and act upon the messages illness brings.- Don't let herbalism become what acupuncture has - licensed, squabbling over recognition, standardizing treatment. And this from a man who, though he regrets it, spearheaded the original licensing push by acupuncturists.

Chris Hobbs talked about herbs for the respiratory tract. (His powerpoint for the lecture should be available soon). Some new info for me:- Useful expectorants: young fresh tips of English ivy; Maidenhair ferns; Smilacina (False Solomon's seal) roots.- Willow bark should be collected in the spring, well before leaves appear, and only from small, juicy branches. Its aromatic, wintergreen-like smell should be clear and strong. Higher elevation sources seem more potent.- Honeysuckle (Lonicera japonica) for fevers - cooling and delicious!

There was an infectious disease round-table in which I participated. We talked about the emerging problem of antibiotic resistance (esp. MRSA in clinical herbal practice) and herbal approaches to treatment: Echinacea, Baptisia, Cryptolepsis, Artemisia, and topical preparations. We also discussed the threat of pandemic influenza, and divided its risk into two main categories: the pathogen itself, which can kill people with weak immunity (young and old, especially); and the inflammatory cytokine storm that accompanies the infection in those with strong immunities, basically liquefying their lungs. In the latter case, immunomodulants like Scutellaria baicalensis (and perhaps high doses of Echinacea alkylamides, see above) might be more useful than actual antivirals.

Finally, it was great to see old friends and make new ones. Mischa is getting a study together on the use of Wild Carrot seed in contraception. I got to meet Maria, of Dirt Under My Nails fame. Check out her symposium post for info on lectures I didn't attend. And many thanks to Jillian, who was kind enough to host us, join in some late-night music making, and expose us to some interesting Aguardiente combos from the Amazon. I came home inspired with new ideas, and excited about the new herb school we're starting in Montpelier.

11.01.2007

This is a continuation of the conference report for this year's gathering of the American Herbalists' Guild.Pam Fischer, from Berkeley, CA, discussed the free clinics she's set up and been involved with for over 7 years. It was an interesting discussion, and I enjoyed looking at diverse models of herbal care accessibility, hearing 7Song talk about the Ithaca Free Clinic, and mentioning my own work. Pam had some interesting models to discuss, and some pearls of wisdom from her own experience:- herbalists have been joining up with pot clubs in the Berkeley area to offer their help with medicinal herbs other than Cannabis. Great idea! Tough here in Vermont.- echoing my own experience, Pam recommends hiring a paid administrator / staff person to prevent volunteer burnout. I highly recommend this.- running a clinic that is completely "free" can be politically correct, but it can also shut out folks who might want to contribute financially. Pam's clinic is entirely by donation; she calls it a "community herbal clinic", and focuses on its role in supporting the herbal community rather than its "freeness". This is an interesting point; I'm still not sure where I stand on this issue (having generally seen good compliance rates, good followup, and plenty of donations even when advertising as "free").- compensation for the herbalists is derived from a pool of funds. This pool is fed by individual private practice sessions, donations, apothecary sales, and student tuitions.

Paul Bergner, of Medical Herbalism fame, gave a nice introduction on energetic assessment and its importance in the herbal consultation and in formulating a treatment plan. After all, if we can't tailor our recommendations to individual constitutions, we're just treating disease! Generally, herbs work a heck of a lot better if they're matched to individual constitutions. This also is the basis of one of my complaints with the double blind, placebo-controlled trial: almost none have a way of dividing populations based on simple constitutional profiles: diaphoretics may help improve circulation in a 'hot' constitution with cold hands and feet, but will do little for a 'cold' constitution with the same issues. Some interesting points:- Three polarities: vitality / deficiency; hot / cold; moist / dry. You can figure these out with just a little common sense and good observation!- If there is low vitality, there are usually three potential reasons why: low rest, low digestive fire, or poor food. To this I'd add an assessment of exercise and movement, too.- As vitality is restored and the physiology becomes more capable of producing an inflammatory reaction, it will. This is the 'healing crisis', and follows Hering'sLaw of Direction of Cure.- Healing crises show up in personal relationships (plateau -> conflict -> higher level) and in society as a whole. If fact, Paul made the case that our society is very deficient in vitality, because it doesn't react violently anymore. There are few protests, and little activism, compared to 45 years ago. His assessment: an acute illness that flared in the 1960s was generally suppressed. Emotional symptoms followed, and were expressed in the 1980s with its greed, corruption, and societal stratification. This was also suppressed, and now in the 21st century our illness has become spiritual...- The rest of the lecture was a review of pulse and tongue assessment and its role in determining relative degrees of heat and moisture. Paul was clear to say, and I agree, that pulse and tongue are merely corroborating signs, and not definitive diagnostic tools.

...more to come, including Simon Mills and acupharmacology; Robert Duggan and some amazing philosophy of healing; infectious disease clinical roundtable; some herbs for the respiratory tract as suggested by Chris Hobbs; and original research by Kevin Spellman on Echinacea, Dandelion, and autoimmune inflammation.